Aortic Dissection

Sometimes called “dissecting aneurysm”, this is not an aneurysm, but a separation of the aortic wall layers.

Blood enters the aortic wall through a small tear in the intima, or inner lining of the artery. Under pressure, it then dissects through the wall, creating a false lumen or false channel. Sometimes there is a second tear through which the blood re-enters the true aortic lumen; sometimes the blood breaks through the wall to the thorax or retroperitoneal spaces.

Dissections are usually associated with hypertension and atherosclerosis, although certain genetic conditions (Marfan’s syndrome) can predispose to dissection.

Symptoms include a severe tearing pain in the back as the dissection travels distally, changes in blood pressure and distal pulses, and loss of various physiologic functions if the dissection blocks the blood supply to major organs.